[Advance in drug treatment of primary and familial hypercholesterolemia].
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Animals↗
Biomedical subjects
K Liu
Publications and source records attributed to K Liu.
The CARDIA dietary history: development, implementation, and evaluation.
To meet the objectives for dietary assessment in the Coronary Artery Risk Development in Young Adults (CARDIA) prospective study, we developed a dietary history to provide accurate and reliable quantitative data on habitual individual nutrient intakes at baseline. The CARDIA dietary history was an interviewer-administered method that included a short questionnaire regarding general dietary practices followed by a comprehensive food frequency questionnaire about typical intake of foods using the previous month as a reference for recall. For each broad category of foods, participants were questioned in detail about specific foods only if they indicated that they consumed foods from that category. Follow-up questions for selected foods concerned serving size, frequency of consumption, and common additions to these foods. Provision was made for reporting foods not found in the food frequency list. The interview took approximately 45 minutes. Cue cards prompted responses and plastic food models assisted in estimating usual amounts consumed. A precoded format standardized coding for reported items and established the detail needed for recall during the interview. Baseline nutrient analyses from the CARDIA dietary history provided estimates that agreed reasonably well with expected caloric intake for body mass index according to the age- and sex-specific Recommended Dietary Allowances, but were higher than those reported from 24-hour recalls for comparable age, sex, and race groups in the second National Health and Nutrition Examination Survey. The CARDIA dietary history is a comprehensive assessment tool that can provide a dietitian with detailed information regarding habitual eating patterns and nutrient intakes among adults.
Adult↗
Enantioselective hydrolysis of oxazepam 3-acetate by esterases in human and rat liver microsomes and rat brain S9 fraction.
Rates of hydrolysis of racemic and enantiomeric oxazepam 3-acetates (OXA) by esterases in human and rat liver microsomes and rat brain S9 fraction were compared. When rac-OXA was the substrate, esterases in human and rat liver microsomes were highly enantioselective toward (R)-OXA. In contrast, esterases in rat brain S9 fraction were highly enantioselective toward (S)-OXA. Hydrolysis rates of rac-OXA were highly dependent on the amount of esterases used. At 0.05 mg protein equivalent of esterases and 150 nmol of rac-OXA per ml of incubation mixture, the (R)-OXA was hydrolyzed 3.6-fold and 18.5-fold faster than (S)-OXA by rat and human liver microsomes, respectively. The specific activities (nmol of OXA hydrolyzed/mg microsomal protein/min) of liver microsomes in the hydrolysis of enantiomerically pure (R)-OXA were approximately 120 (rat) and 1,980 (human), and in the hydrolysis of enantiomerically pure (S)-OXA were 4 (rat) and 7 (human), respectively. In the incubation of rac-OXA with rat brain S9 fraction, (S)-OXA was hydrolyzed approximately 6-fold faster than (R)-OXA. Results also indicated an enantiomeric interaction in the hydrolysis of rac-OXA by esterases in rat and human liver microsomes; the presence of (R)-OXA stimulated the hydrolysis of (S)-OXA, whereas the presence of (S)-OXA inhibited the hydrolysis of (R)-OXA. In rat brain S9 fraction, the presence of (R)-OXA inhibited the hydrolysis of (S)-OXA, whereas the presence of (S)-OXA appeared to have stimulated the hydrolysis of (R)-OXA.
Animals↗
Maternal serum alpha-fetoprotein levels in pregnancies complicated by diabetes: implications for screening programs.
Maternal serum alpha-fetoprotein may be reduced in diabetic pregnancies, but the association with elevated glycosylated hemoglobin has been controversial. We tested the hypothesis that reductions in maternal serum alpha-fetoprotein may reflect the same phenomena that can also impair normal rates of embryo growth in the presence of poorly compensated maternal diabetes. If so, associations would be expected among maternal serum alpha-fetoprotein, embryo rates of growth, and levels of glycosylated hemoglobin reflective of regulation of maternal diabetes during the period of organogenesis. We found maternal serum alpha-fetoprotein levels in 93 pregnant patients with diabetes to be negatively associated with the earliest (4 to 12 weeks) glycosylated hemoglobin determinations. At glycosylated hemoglobin values greater than 9.6% (which approximates the upper quartile), all maternal serum alpha-fetoprotein values fell below the median for patients without diabetes (below 0.8 multiple of the median after weight adjustment). Moreover, there was a trend for pregnancies with lower maternal serum alpha-fetoprotein levels and higher glycosylated hemoglobin values to also demonstrate early fetal growth delay as measured by ultrasonography.
Embryo, Mammalian↗
Lateral sural cutaneous artery island flap in the treatment of soft tissue defects at the knee.
This paper describes a flap for covering defects around the knee. Dissections of 20 legs showed that in the majority the lateral sural cutaneous artery branched from the popliteal artery and descended along the posterolateral aspect of the leg together with two venae comitantes and the lateral sural cutaneous nerve. An island flap was designed, pedicled on these vessels and nerve, and was used in 17 patients with defects around the knee, including acute trauma (three cases), soft tissue tumours (three cases), unstable scar or ulcer (seven cases), and chronic osteomyelitis or infected open fractures with tissue loss (four cases). All the flaps survived entirely and possessed normal sensation. Furthermore, it was not necessary to sacrifice the main vessels of the lower leg.
Adolescent↗
The utility of indirect measures of obesity in racial comparisons of blood pressure. CARDIA Study Group.
The associations between estimates of obesity derived from anthropometric measurements (body mass index, the sum of three skin folds, and the computed percent body fat) and blood pressures were examined by multiple regression analysis in 4508 young black and white adults. The three estimates of obesity yielded similar results in regression analyses. The strength of associations between these three estimates of obesity and systolic and diastolic blood pressures did not differ in black and white subjects of either sex. All three estimates lead to the same interpretation of the relationship between obesity and systolic or diastolic blood pressure. Estimated percent body fat offered no advantage over the other indices in this context.
Adult↗
Medicaid spenddown in nursing homes.
This paper employs information from nationally representative surveys to examine the incidence and causes of Medicaid spenddown among disabled elderly persons. About 10% of nursing home discharges experience "asset spenddown," the process of converting from private pay to Medicaid. In contrast, over 50% of nursing home patients remain private pay throughout their stays. In addition, becoming a Medicaid patient is more common among community residents than among nursing home residents. Implications of findings for health care policies are discussed.
Aged↗
Comparison of three weight-for-height indices in blood pressure studies in children.
Associations between blood pressures and three indices commonly used to assess relative obesity (weight (kg)/height (m)2, weight (kg)/height (m)3, and weight (kg)/height (m)p) were examined in a multiracial sample of children attending private schools in Chicago, Illinois. The 1,723 boys and 1,878 girls were 5-10 years old at the time of the survey (1975-1978). Inclusion of white, black, Hispanic, and Asian children permitted comparison of the relation between anthropometric variables and blood pressures across racial groups. The three weight-for-height indices used as estimates of relative obesity yielded nearly identical regression models, suggesting that, in spite of ongoing debate about the most appropriate index for describing relative obesity in children, it makes little difference which index is used.
Blood Pressure↗
Determinants of transitory and permanent nursing home admissions.
This article describes an analysis of data from the 1982-84 National Long-Term Care Demonstration Project to estimate the risks of any nursing home admission, a temporary or transitory admission, and a permanent admission. Using a multinomial logit model, the relative predictive power of several individual characteristics on nursing home use and admission type were evaluated. It was found that the cognitively impaired subgroup was at the greatest risk of entering a nursing home, especially on a permanent basis. The results also demonstrated that the combination of cognitive impairment and functional impairment further increased the risk of a nursing home admission, particularly a permanent one. Other subgroups that had high probabilities of experiencing a nursing home admission were whites, nonhomeowners, those living alone, and those with prior nursing home stays. The findings identified several aged subgroups that were at no greater risk of nursing home admission regardless of admission type: older persons who were unmarried, had a low income, had no assets, and those on Medicaid.
Activities of Daily Living↗
Recent changes in service use patterns of disabled Medicare beneficiaries.
An analysis was made of the pre- and post-patterns of Medicare Part A service use using the samples of the 1982 and 1984 National Long-Term Care Surveys linked to the Medicare Part A bill files and mortality reports. The analysis was conducted both for the total elderly Medicare beneficiary population and for the community resident disabled population--a group felt to be particularly vulnerable to any adverse effect of the prospective payment system's induced change in service use. The expected changes in Medicare service patterns were identified, but there was no evidence of adverse changes in outcome--even for select vulnerable populations.
Aged↗
[Smooth muscle tumors of gastrointestinal tract: a study on correlation between pathology and prognosis and histogenesis].
Seventy three cases of gastrointestinal smooth muscle tumors (GISMT) were collected and their correlation between pathology and prognosis and their histogenesis was studied, microscopically, the following parameters were evaluated: 1. cellularity; 2. grade of differentiation; 3. nuclear pleomorphism; 4. mitotic rate/10 HPF. All cases were followed up, but from only 47 information was elicited. To study the histogenesis, the technique of immunohistochemical staining to desmin, S-100 protein was used in all the cases and five were examined by EM. The results showed that the mitotic rate was the most important and reliable pathological parameter used to differentiate between benign and malignant tumors, and to evaluate the prognosis of a given tumor; in the cases which showed active mitosis, tumor size was important to evaluate the prognosis; the other histologic parameters of less, if any, significance in evaluation of prognosis. The authors supported the hypothesis that GISMT might mainly be derived from primary mesenchymal cells potentiated with smooth muscle cells differentiation. The hypothesis that GISMT are derived from nerve tissue waits for further evidence.
Adolescent↗
Salter's osteotomy for the management of joint capsule.
Capsulotomy in primary Salter's osteotomy shaped by T or + and is difficult to tighten joint capsule. A new technique or L-shaped incision i.e., a L-shaped incision on the right hip and a reversed L-shaped incision on the left is designed to incise and sew the capsule. This technique can make the acetabulum fully exposed, and the capsule can be conveniently tightened with overlapping sutures. When it is combined with modified external fixation, redislocation after operation can be avoided.
Acetabulum↗
Morbidity, disability, and long-term care of the elderly: implications for insurance financing.
A scarcity of empirical information to specify appropriate provisions and base rates for coverage has hindered the development of long-term-care (LTC) insurance. Data from three nationally representative surveys on the prevalence of morbidity and functional limitations among the elderly population suggest that health status among older Americans is highly dynamic, especially at higher disability levels. The bioactuarial data may help insurers define potential markets of purchasers of policies, and identify the numbers of persons with disabilities severe enough to trigger use of benefits. If the accuracy of individual service predictions could be increased further, reserve requirements and overall costs to LTC insurance carriers might be reduced.
Aged↗
Costs of community care for disabled elderly persons: the policy implications.
This paper presents results from our analysis of the National Long-Term Care Channeling Demonstration Project data. We used this data to estimate the costs of community-based long-term care services for disabled elderly persons. Our results indicate that both costs per community day and the likelihood that any costs would be incurred, would increase noticeably if a program similar to the Channeling project were implemented nationally. To illustrate the effects of disability-based eligibility criteria on total program costs, we present unit costs in conjunction with numbers of persons having different levels of ADL dependency.
Activities of Daily Living↗
The hemodynamics and clinical effects of labetalol in hypotensive anesthesia.
Labetalol is a relatively new and unique hypotensive agent that has both alpha- and beta-adrenoceptor blocking properties. 12 patients in fit physical condition who underwent elective oral surgery were subject to hypotensive anesthesia with labetalol to assess the hemodynamic aspects and clinical effects of the drug. All of them had their anesthesia maintained with halothane and N2O in 50% O2 supplemented by fentanyl and vecuronium. Initiation of deliberate hypotension was made with intravenous bolus of labetalol at 0.5 mg/kg and the ideal level of mean arterial pressure at 55 +/- 5 mm Hg was maintained with adjustment of the concentration of halothane. At the termination of deliberate hypotension, the blood pressure was recuperated to the baseline level by lowering the concentration of halothane and administration of 0.5-0.6 mg intravenous atropine. Our results showed that the total dose of labetalol used was 44 +/- 13 mg and blood loss amounted to 354 +/- 136 ml. Important changes of hemodynamic parameters before and after labetalol included the fall of mean BP, HR, mean PAP, CI, LVSWI, SVRI, PVRI and O2 delivery and the increasing of O2 extraction. As to CVP, PCWP, SVI, O2 consumption and shunting the alterations were minimal. Blood gas analysis showed that, save a slight fall of pH indicating mild metabolic acidosis, the PaO2 and PaCO2 remained unchanged following the use of labetalol. Labetalol-induced hypotension could be effectively reversed by using of atropine as shown in our study and all the patients recovered uneventfully from hypotensive anesthesia. They were entirely free from any complication or sequela relevant to the deliberate hypotension after one year's follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Sacroepidural analgesia for post-operative pain relief in children.
For evaluation of the practicality of epidural analgesia for alleviation of post-operative pain, 66 class I or II patients with age ranging from 6 months to 12 years undergoing elective surgical procedures below the lower abdomen were enrolled for study during the period from January to April 1989. Before termination of general anesthesia a single dose of 0.25% bupivacaine, respectively at 0.25 mL/kg (Ideal body weight), 0.5 mL/kg, 0.75 mL/kg, 1.0 mL/kg and 1.25 mL/kg was given sacroepidurally to 5 groups of patients. Our results showed that for surgery below the lower abdomen a dose at 1.0 mL/kg was sufficient to suffice the need for relief of post-operative pain. At this dosage it achieved a neural block up to T8-T6 and provided with an analgesia that could last 6.0 +/- 2.1 hours. During the entire course there were no untoward effects such as hypotension, bradycardia, vomiting and shivering to come about. Therefore, sacroepidural analgesia with 0.25% bupivacaine at fitting single dose is safe and feasible in children as far as relief of post-operative pain for procedures below the lower abdomen is concerned.
Analgesia, Epidural↗
Rectal ketamine versus intranasal ketamine as premedicant in children.
The effects of ketamine administered per nasus (PN) or per rectum (PR) as pre-anesthetic medication for day surgery was studied in 70 ASA class I children with age ranging from 6 months to 6 years. Before study they were divided into 3 groups. Group A (n = 25) received no premedicant, while group B (n = 25) and group C (n = 20) received ketamine 6 mg/kg PR and 3 mg/kg PN as premedicant respectively. It was demonstrated that patients in group B and group C accepted the facemask during induction of anesthesia more willingly and peacefully than those in group A. In group B and group C there was accompaniment of analgesic effect seen postoperatively. The incidence of adverse reactions (nausea, vomiting, laryngospasm, salivation, respiratory depression) was low following the use of PR or PN ketamine although the children in these two groups emerged more belatedly from anesthesia and stayed in the post-anesthetic recovery room (PARR) for a longer time than in group A.
Administration, Intranasal↗
[Nursing care of leukemia patients in cytolysis syndrome by chemotherapy].
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Acute Kidney Injury↗